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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the unintended consequences of meaningful use is that it provides a real hospital EHR vendor lock in. Certainly hospital EHR vendors have a pretty significant lock in even without meaningful use. Saying that switching hospital EHR software is a large project is a supreme understatement. However, if that wasn’t lock in enough, meaningful use makes it so that I can’t imagine a single hospital switching EHR software during the 5 year meaningful use cycle.

In a Meaningful Use Monday post on EMR and HIPAA, Lynn Scheps covered the details of Switching EHR software in the middle of meaningful use. So, yes it is technically possible and CMS has covered those that do end up switching EHR software. As the meaningful use stages progress I could even see this happening relatively frequently in the ambulatory EHR arena. I don’t see this happening at all in the hospital EHR arena.

You might ask why? I can’t imagine a hospital going to the effort of reconciling the details of meaningful use between two systems. Not to mention the implementation time for a hospital EHR system is so long that you’d likely lose out on a year of meaningful use money anyway. I don’t see any hospital CIO making this choice.

I made the argument in a previous post that much like ERP software, there will be an opportunity for some EHR software to displace the current vendor. I suggested this is most likely during the renewal or upgrade period. I still think this is sound reasoning and would be the time a hospital CIO could make the case for change. Although, I’m sure that meaningful use and the EHR incentive money will likely mean that many hospital CIOs take the upgrade cost on the chin instead of switching software.

Makes me wonder if EHR vendors will use this to their advantage when it’s time to deal with renewals and upgrades. I’d hope this wouldn’t be the case, but I won’t be surprised if it happens.

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

According to the research firm, which interviewed 104 MU-compliant providers, both large and small hospitals successfully passed through Meaningful Use attestation. However, the choice of vendor did seem to make a difference — one which, if KLAS is right, hospitals would be ill-advised to ignore.

KLAS concluded that hospitals using Allscripts, Healthland, HMS, McKesson had a harder time moving ahead on MU than organizations that went with MEDITECH, Cerner, CPSI and Epic. (It should be noted that while MEDITECH had the highest number of successful attesters, most of those came from a single large IDN, which makes it a bit hard to tell whether the IDN’s execution strategy or the product deserves the credit.)

One surprising bit of data, for me at least, that community hospitals were having an easier time covering their costs than larger IDNs. KLAS notes that this varied from vendor to vendor, but didn’t name which were the higher performers.

Why the difference? My guess is that the bigger IDNs bought “Extormity” software (such as Epic and Cerner) and are having a hard time paying for it; that they have higher integration costs; and that they’re dealing with larger piles of smoking heaps of machinery (oh, excuse me, I meant very outdated mainframes and what have you).

As for problems, providers obviously had plenty to share. Reporting and problem list functions were the most commonly reported challenges, KLAS said. In these areas, it seems, all vendors performed poorly, including the ever-popular Epic Systems.